Health Information

Guides you through the decision to have a coronary calcium scan. Explains why a coronary calcium scan is done and what it can show. Lists treatments that might come after a coronary calcium scan. Lists risks and benefits. Includes interactive tool to help you decide.

Guides you through the decision to have a coronary calcium scan. Explains why a coronary calcium scan is done and what it can show. Lists treatments that might come after a coronary calcium scan. Lists risks and benefits. Includes interactive tool to help you decide.

Heart Disease Risk: Should I Have a Coronary Calcium Scan?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Heart Disease Risk: Should I Have a Coronary Calcium Scan?

Your options

This information is only for people who are curious about
their risk for heart disease but don't have angina symptoms, such as chest pain or pressure.

Key points to remember

A coronary calcium scan checks for calcium buildup in the
coronary arteries. Calcium in these arteries may be a sign of heart disease.
A high score on a calcium scan can mean that you have a higher chance of having
a heart attack than someone with a low score.

The results of a coronary calcium scan may prompt you to make
some lifestyle changes, such as exercising, eating better, losing weight, and quitting
smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

People who are at medium risk for heart disease will get the
most benefit from this test. Your doctor can help you find out your risk. Knowing your risk for a heart attack is a key part of your decision to get a scan.

A calcium scan is not helpful to patients who have a low or high risk of heart disease.

A calcium scan can give your doctor more information
about your risk for heart disease. If you have a high score, you and your doctor may decide to start or change treatment to lower your risk.

You
could get a high score from the test even if your arteries do not have signs of heart disease.
This could lead to other tests or treatments that you don't need.

Not all arteries that have early signs of heart disease have calcium. So you could get a low
calcium score and still be at risk.

Not all health plans will pay
for this test. The cost can range from about $100 to $400.

A
coronary calcium scan is a test for people who have no
symptoms of heart disease but may be at risk for getting it. The test uses
computed tomography (CT) to check for calcium buildup
in
plaque on the walls of the coronary arteries. The
coronary arteries wrap around the heart and supply it with blood and oxygen.
Calcium in these arteries is a sign of heart disease.

During the test, a CT scan takes pictures of your heart in thin sections.
The result is a score based on the amount of calcium seen on the scan. The
higher your calcium score, the higher your risk for a heart attack. The test
takes about 30 minutes.

Most health insurance plans don't pay for
coronary calcium scanning. The cost can range from about $100 to $400.

CT angiography is a test that uses computed tomography to see if an artery is narrowed or blocked. It's different from a coronary calcium scan and may be best after you already have symptoms of heart disease and other test results are not clear.

Talk with your doctor if you
want to know more about CT angiography. This Decision Point is about coronary
calcium scanning.

Your doctor
may want you to have a coronary calcium scan if it can help you and your doctor make decisions about how to lower your risk for heart disease, heart attack, and stroke.

This test might be most helpful for people who do not have heart disease
but who are at medium risk for heart disease.
Your doctor can help you know your risk of heart disease, heart attack, and stroke. Your doctor will look at things that put you at risk, including blood pressure, cholesterol, diabetes, and your age, sex, and race.

In most cases, the results from your physical exam and other tests will give your
doctor enough information about your risk for heart disease.

A coronary calcium scan is not advised for routine screening for
coronary artery disease.1 This test might not tell your doctor any more about your risk for heart disease than your risk factors do. Risk factors are things that can increase your risk for heart disease, such as
diabetes,
high blood pressure,
high cholesterol, and smoking.

This screening test is not for you if:

You don't have any risk factors for heart disease, so you have a low risk of a heart attack.

You are at high risk for heart disease or you were diagnosed with heart disease. (You should already be under a doctor's care.)

This test may not be right for you if you are a man younger than 40 or a woman younger than 50. This is because younger people typically do not have much calcium buildup in their arteries yet.

After the scan, you will
get a test result that is a number. This is your calcium score. The score can
range from 0 to more than 400. Any score over 100 means that you are likely to
have heart disease. The higher your score, the greater your chance of having a
heart attack.

People who score between 100 and 400 or higher, and
who are at medium risk for heart disease, are more likely to have a heart
attack in the next 3 to 5 years than people who score 0.2

Many people only learn that they have heart disease when they have a
heart attack. A coronary calcium scan is one way to find out if you have early
heart disease before it gets worse. After you know your risk, you and your doctor can make decisions about how to lower it. You can make
lifestyle changes such as having a heart-healthy eating plan, staying at a healthy weight, getting more exercise,
and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

A coronary calcium
scan can give your doctor more information about your risk for heart disease,
especially if you already have risk factors. Then you can make decisions about how to lower your risk. For example, you and your doctor can use your score plus your other risk factors to decide whether cholesterol medicine is right for you.

You could get a high score from the test even
if your arteries do not have signs of heart disease. This could lead to extra tests that you don't
need. Or it could cause you to worry when there's no reason. But these kinds of
results are most likely to happen in people who are at low risk for heart
disease. So if you already know that you're at low risk, you shouldn't get this
test.

Not all arteries that have early signs of heart disease have calcium. A low test score may
make you feel safe even though you're still at risk.

There is a slight chance of developing cancer from having cardiac calcium scoring. The chance is higher in people who have many radiation tests. If you are concerned about this risk, talk to your doctor about the amount of radiation this test may give you and confirm that the test is needed.

Personal stories about coronary calcium scanning

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My mom had
a heart attack in her early 60s, followed by bypass surgery. She didn't have a
clue that she had heart disease. I don't want that to happen to me. I already know I have a couple of health issues that raise my risk for heart disease. So I'm going
to ask my doctor about getting a coronary calcium scan to check my risk.

Rose, age
48

My wife has been bugging me to get this
test. So I asked my doctor about it. He said my risk for getting heart disease
is pretty low even though I have high blood pressure. I'm taking medicine for
that and for high cholesterol. I'm also trying to eat better and exercise. I
just don't think the test is going to tell me more about my risk than I already
know.

Jeffrey, age
56

My doctor says I am at risk for heart disease. She wants me to have a coronary calcium scan so that we can get a better idea of my risk of a heart attack. Then, we can decide whether I should start taking medicine so I can lower my risk. I like the idea of having all the information before I make decisions. So I'm going to have the test.

Tony, age
53

I get a physical exam from my doctor every
year, and she says I'm in pretty good shape. But ever since I passed 50, I've
been worried about heart disease. I saw an ad for this test in the newspaper
and asked my doctor about it. It turns out that in healthy people like me, the
test results aren't very reliable. I'm going to just keep getting an annual
checkup.

Maria, age
54

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have a coronary calcium scan

Reasons not to have a coronary calcium scan

I need more information about my risk so I can commit to making lifestyle changes or taking medicines.

I already know that I should make some lifestyle changes to keep my heart healthy.

More important

Equally important

More important

It's worth it to me to pay for this test myself.

My insurance won't pay for this test, and I can't afford it.

More important

Equally important

More important

I want to take any tests that could help me find out my risk for heart disease.

I don't want to take tests I don't need.

More important

Equally important

More important

I want to take this test because I need more information about my risk for having a heart attack.

I already know my risk for having a heart attack, so I don't need this test.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having a coronary calcium scan

NOT having a coronary calcium scan

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

Can anyone who is worried about heart disease benefit from a coronary calcium scan?

YesNo, that's wrong. People who are at medium risk for heart disease will get the most benefit from this test. If you are at low risk, the test results may not be reliable. If you are at high risk, you should already be under a doctor's care.

NoYou're right. People who are at medium risk for heart disease will get the most benefit from this test. If you are at low risk, the test results may not be reliable. If you are at high risk, you should already be under a doctor's care.

I'm not sureIt may help to go back and read "Who should get a coronary calcium scan?" People who are at medium risk for heart disease will get the most benefit from this test.

2.

Does a high score on a coronary calcium scan always mean you have heart disease?

YesNo, that's not right. You could get a high score on the test even if your arteries do not have signs of heart disease. That could lead to other tests or treatments you don't need.

NoThat's right. You could get a high score on the test even if your arteries do not have signs of heart disease. That could lead to other tests or treatments you don't need.

I'm not sureIt may help to go back and read "What are the risks?" You could get a high score on the test even if your arteries do not have signs of heart disease.

3.

Could you still be at risk for heart disease even if you get a low calcium score on the test?

YesThat's right. Not all arteries that have early signs of heart disease have calcium. So you could get a low score on the test and still be at risk.

NoSorry, that's wrong. Not all arteries that have early signs of heart disease have calcium. So you could get a low score on the test and still be at risk.

I'm not sureIt may help to go back and read "What are the risks?" Not all arteries that have early signs of heart disease have calcium. So you could get a low score on the test and still be at risk.

4.

Is having a coronary calcium scan the only way to tell if you need to make lifestyle changes to help your heart, such as exercising, eating better, and not smoking?

YesSorry, that's wrong. Even without taking the test, you can make healthy lifestyle changes that can help your heart.

NoYou are right. Even without taking the test, you can make healthy lifestyle changes that can help your heart.

I'm not sureIt may help to go back and read "What are the benefits of a coronary calcium scan?" Even without taking the test, you can make healthy lifestyle changes that can help your heart.

Budoff M, et al. (2006). Assessment of coronary artery
disease by cardiac computed tomography: A scientific statement from the
American Heart Association Committee on Cardiovascular Imaging and
Intervention, Council on Cardiovascular Radiology and Intervention, and
Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation, 114(16): 1761–1791.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Heart Disease Risk: Should I Have a Coronary Calcium Scan?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have a coronary artery calcium scan.

Don't have a coronary artery calcium scan.

This information is only for people who are curious about
their risk for heart disease but don't have angina symptoms, such as chest pain or pressure.

Key points to remember

A coronary calcium scan checks for calcium buildup in the
coronary arteries. Calcium in these arteries may be a sign of heart disease.
A high score on a calcium scan can mean that you have a higher chance of having
a heart attack than someone with a low score.

The results of a coronary calcium scan may prompt you to make
some lifestyle changes, such as exercising, eating better, losing weight, and quitting
smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

People who are at medium risk for heart disease will get the
most benefit from this test. Your doctor can help you find out your risk. Knowing your risk for a heart attack is a key part of your decision to get a scan.

A calcium scan is not helpful to patients who have a low or high risk of heart disease.

A calcium scan can give your doctor more information
about your risk for heart disease. If you have a high score, you and your doctor may decide to start or change treatment to lower your risk.

You
could get a high score from the test even if your arteries do not have signs of heart disease.
This could lead to other tests or treatments that you don't need.

Not all arteries that have early signs of heart disease have calcium. So you could get a low
calcium score and still be at risk.

Not all health plans will pay
for this test. The cost can range from about $100 to $400.

FAQs

What is a coronary calcium scan?

A
coronary calcium scan is a test for people who have no
symptoms of heart disease but may be at risk for getting it. The test uses
computed tomography (CT) to check for calcium buildup
in
plaque on the walls of the coronary arteries. The
coronary arteries wrap around the heart and supply it with blood and oxygen.
Calcium in these arteries is a sign of heart disease.

During the test, a CT scan takes pictures of your heart in thin sections.
The result is a score based on the amount of calcium seen on the scan. The
higher your calcium score, the higher your risk for a heart attack. The test
takes about 30 minutes.

Most health insurance plans don't pay for
coronary calcium scanning. The cost can range from about $100 to $400.

CT angiography is a test that uses computed tomography to see if an artery is narrowed or blocked. It's different from a coronary calcium scan and may be best after you already have symptoms of heart disease and other test results are not clear.

Talk with your doctor if you
want to know more about CT angiography. This Decision Point is about coronary
calcium scanning.

Who should get a coronary calcium scan?

Your doctor
may want you to have a coronary calcium scan if it can help you and your doctor make decisions about how to lower your risk for heart disease, heart attack, and stroke.

This test might be most helpful for people who do not have heart disease
but who are at medium risk for heart disease.
Your doctor can help you know your risk of heart disease, heart attack, and stroke. Your doctor will look at things that put you at risk, including blood pressure, cholesterol, diabetes, and your age, sex, and race.

In most cases, the results from your physical exam and other tests will give your
doctor enough information about your risk for heart disease.

A coronary calcium scan is not advised for routine screening for
coronary artery disease.1 This test might not tell your doctor any more about your risk for heart disease than your risk factors do. Risk factors are things that can increase your risk for heart disease, such as
diabetes,
high blood pressure,
high cholesterol, and smoking.

This screening test is not for you if:

You don't have any risk factors for heart disease, so you have a low risk of a heart attack.

You are at high risk for heart disease or you were diagnosed with heart disease. (You should already be under a doctor's care.)

This test may not be right for you if you are a man younger than 40 or a woman younger than 50. This is because younger people typically do not have much calcium buildup in their arteries yet.

What do the results mean?

After the scan, you will
get a test result that is a number. This is your calcium score. The score can
range from 0 to more than 400. Any score over 100 means that you are likely to
have heart disease. The higher your score, the greater your chance of having a
heart attack.

People who score between 100 and 400 or higher, and
who are at medium risk for heart disease, are more likely to have a heart
attack in the next 3 to 5 years than people who score 0.2

After you have the test, talk with your doctor
about your results.

What are the benefits of a coronary calcium scan?

Many people only learn that they have heart disease when they have a
heart attack. A coronary calcium scan is one way to find out if you have early
heart disease before it gets worse. After you know your risk, you and your doctor can make decisions about how to lower it. You can make
lifestyle changes such as having a heart-healthy eating plan, staying at a healthy weight, getting more exercise,
and quitting smoking. You might also decide to take medicine such as cholesterol or blood pressure medicine.

A coronary calcium
scan can give your doctor more information about your risk for heart disease,
especially if you already have risk factors. Then you can make decisions about how to lower your risk. For example, you and your doctor can use your score plus your other risk factors to decide whether cholesterol medicine is right for you.

What are the risks?

You could get a high score from the test even
if your arteries do not have signs of heart disease. This could lead to extra tests that you don't
need. Or it could cause you to worry when there's no reason. But these kinds of
results are most likely to happen in people who are at low risk for heart
disease. So if you already know that you're at low risk, you shouldn't get this
test.

Not all arteries that have early signs of heart disease have calcium. A low test score may
make you feel safe even though you're still at risk.

There is a slight chance of developing cancer from having cardiac calcium scoring. The chance is higher in people who have many radiation tests. If you are concerned about this risk, talk to your doctor about the amount of radiation this test may give you and confirm that the test is needed.

Why might your doctor recommend this test?

You are at medium risk for heart disease, based on your risk
factors.

Your doctor thinks that the results of this test could
change your treatment and lower your risk for heart disease.

2. Compare your options

Have a coronary calcium
scan

Don't have a coronary
calcium scan

What is usually involved?

You will lie on a
table connected to the CT scanner. The table slides into the opening in the
machine, and the scanner moves around your body. The test takes about 30
minutes.

Instead of having a CT scan,
your doctor gets information about your heart disease risk from a physical exam
and other tests.

You make healthy lifestyle changes or take medicines that can help
your heart without taking a test.

What are the benefits?

A coronary calcium
scan can give your doctor more information about your risk for heart disease,
especially if you have several risk factors.

The results of the test may prompt you to make lifestyle changes
or take medicines that can help your heart.

You don't pay for a test you may
not need. Most insurers do not pay for this test.

What are the risks and side effects?

The
test can give a high score even if your arteries do not have signs of heart disease. This might
lead to tests or treatment you don't need.

Not all arteries that have signs of heart disease have calcium. So you could get a low
test score and still be at risk.

Most health insurers don't pay for this test.

If you are at
medium risk for heart disease and don't get a coronary calcium scan, you may
not have all the information you need to reduce your risk.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about coronary calcium scanning

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"My mom had a heart attack in her early 60s, followed by bypass surgery. She didn't have a clue that she had heart disease. I don't want that to happen to me. I already know I have a couple of health issues that raise my risk for heart disease. So I'm going to ask my doctor about getting a coronary calcium scan to check my risk."

— Rose, age
48

"My wife has been bugging me to get this test. So I asked my doctor about it. He said my risk for getting heart disease is pretty low even though I have high blood pressure. I'm taking medicine for that and for high cholesterol. I'm also trying to eat better and exercise. I just don't think the test is going to tell me more about my risk than I already know."

— Jeffrey, age
56

"My doctor says I am at risk for heart disease. She wants me to have a coronary calcium scan so that we can get a better idea of my risk of a heart attack. Then, we can decide whether I should start taking medicine so I can lower my risk. I like the idea of having all the information before I make decisions. So I'm going to have the test."

— Tony, age
53

"I get a physical exam from my doctor every year, and she says I'm in pretty good shape. But ever since I passed 50, I've been worried about heart disease. I saw an ad for this test in the newspaper and asked my doctor about it. It turns out that in healthy people like me, the test results aren't very reliable. I'm going to just keep getting an annual checkup."

— Maria, age
54

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have a coronary calcium scan

Reasons not to have a coronary calcium scan

I need more information about my risk so I can commit to making lifestyle changes or taking medicines.

I already know that I should make some lifestyle changes to keep my heart healthy.

More important

Equally important

More important

It's worth it to me to pay for this test myself.

My insurance won't pay for this test, and I can't afford it.

More important

Equally important

More important

I want to take any tests that could help me find out my risk for heart disease.

I don't want to take tests I don't need.

More important

Equally important

More important

I want to take this test because I need more information about my risk for having a heart attack.

I already know my risk for having a heart attack, so I don't need this test.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having a coronary calcium scan

NOT having a coronary calcium scan

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Can anyone who is worried about heart disease benefit from a coronary calcium scan?

Yes

No

I'm not sure

You're right. People who are at medium risk for heart disease will get the most benefit from this test. If you are at low risk, the test results may not be reliable. If you are at high risk, you should already be under a doctor's care.

2.
Does a high score on a coronary calcium scan always mean you have heart disease?

Yes

No

I'm not sure

That's right. You could get a high score on the test even if your arteries do not have signs of heart disease. That could lead to other tests or treatments you don't need.

3.
Could you still be at risk for heart disease even if you get a low calcium score on the test?

Yes

No

I'm not sure

That's right. Not all arteries that have early signs of heart disease have calcium. So you could get a low score on the test and still be at risk.

4.
Is having a coronary calcium scan the only way to tell if you need to make lifestyle changes to help your heart, such as exercising, eating better, and not smoking?

Yes

No

I'm not sure

You are right. Even without taking the test, you can make healthy lifestyle changes that can help your heart.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

Budoff M, et al. (2006). Assessment of coronary artery
disease by cardiac computed tomography: A scientific statement from the
American Heart Association Committee on Cardiovascular Imaging and
Intervention, Council on Cardiovascular Radiology and Intervention, and
Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation, 114(16): 1761–1791.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Budoff M, et al. (2006). Assessment of coronary artery
disease by cardiac computed tomography: A scientific statement from the
American Heart Association Committee on Cardiovascular Imaging and
Intervention, Council on Cardiovascular Radiology and Intervention, and
Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation, 114(16): 1761–1791.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.